How successful is ``pleural sound sign{''} in the identification of pneumothorax?
Calik, Saniye Goknil and Calik, Mustafa and Girisgin, Sadik and
Karaoglan, Osman and Dundar, Zerrin Defne and Ergin, Mehmet
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Abstract
OBJECTIVE: In the present study, in thorax ultrasonography (USG) Doppler
images obtained from cases with occult pneumothorax, we investigated the
status of pulsatile pleural sounds over the pleural line and called
these as the pleural sound sign (PSS). The purpose of the present study
was to identify the efficacy of the proposed PSS in diagnosing
pneumothorax and to compare it with the other USG findings including the
sliding lung sign (SLS) and seashore sign (SSS).
METHODS: The present study inncluded 66 consecutive patients who were
referred to the emergency unit with a blunt trauma from October 2009 to
January 2010 at a tertiary university hospital.
RESULTS: Of the 66 patients, 34 were in the patient group, and 32 were
in the control group. Males accounted for 66.7\% (n=44) of the study
population. In predicting pneumothorax, the areas under receiver
operating characteristic (ROC) curves of PSSmax and PSSdifference were
0.989 and 0.990, respectively. While the sensitivity of the SLS was 88\%
and the sensitivity of the SSS was 56\%, the specificities of the SLS
and SSS were 100\%. Based on our findings, accuracy ranking was as
follows: PSSmax = PSSdifference > SLS > SSS.
CONCLUSION: New applications of thorax USG are rapidly growing. Our
findings have to be confirmed in a large patient series. PSS is not a
novel method, but it enhanced the importance of USG in the diagnosis of
pneumothorax. We can stipulate that it can replace thorax computed
tomography imaging particularly for the diagnosis of occult
pneumothoraxes.... Show more Show less